Method for rotating a vertebra or vertebrae

ABSTRACT

A method for rotating a vertebra or vertebrae in a spine that is curved using a vertebral osteosynthesis device that includes polyaxial screws, linking rods, clamping parts, tightening nuts, and set screws. The method includes the steps of: implanting two series of the screws, clamping parts, and linking rods; completely tightening the tightening nuts of a first series of screws on the convex side of the spine curvature; completely tightening the set screws of a second series of screws on the concave side of the spine curvature; tightening the tightening nuts of the second series; and tightening the set screws of the first series.

This application claims priority from U.S. Provisional Application 61/105,334 filed Oct. 14, 2008, which is incorporated by reference.

BACKGROUND OF THE INVENTION

It is known to correct deformations of the spine, such as scoliosis or kyphosis, in the frontal plane and/or the sagittal plane. Generally, a correction in a transverse plane (i.e., a plane perpendicular to the axis of the spine) is not carried out, although such a correction may also be desirable.

When a correction in the transverse plane is required, it is known to use a vertebrae adjusting device to exert a torque on the vertebrae and to maintain the vertebrae in the corrected position until the vertebrae are fixed with vertebral fixing equipment including anchoring screws and linking rods. However, this technique has the disadvantage of exerting great transverse stress on screws attached to the vertebrae, inducing a risk of weakening of the anchoring of these screws in the vertebrae, or even ruptures of the vertebrae. Moreover, the surgeon has difficulty precisely evaluating the amount of stress applied.

SUMMARY OF THE INVENTION

An object of the invention is to provide a novel method of rotating one or more vertebra without inducing a risk of weakening of the anchoring of the screws fixed to the vertebrae or of rupture of the vertebrae.

A further object of the invention is to provide a novel method that does not include additional leverage instruments connected to the vertebrae.

A yet further object of the invention is to provide a novel method of rotating one or more vertebra in a progressive and controlled way.

A still further object of the invention is provide a novel method for rotating a vertebra or vertebrae in a spine that is curved using a vertebral osteosynthesis device that includes polyaxial screws, linking rods, clamping parts, tightening nuts, and set screws, where the method includes implanting two series of the screws, clamping parts, and linking rods; tightening the tightening nuts of a first series of screws on the convex side of the spine curvature; tightening the set screws of a second series of screws on the concave side of the spine curvature; tightening the tightening nuts of the second series; and tightening the set screws of the first series.

These and other objects and advantages of the invention will be apparent to those of skill in the art of the present invention after consideration of the following drawings and description of preferred embodiments.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a clamping part in a first embodiment;

FIG. 2 is a side view of this clamping part;

FIG. 3 is a posterior view of a part of a spine having a scoliosis and in which the vertebrae are rotated on the convex side of this spine, which is the right side of this figure;

FIG. 4 is a posterior view of this part of spine after implantation of the vertebrae adjusting device;

FIG. 5 is a transverse view of the spine, in a first step of the method;

FIG. 6 is a view of the spine similar to FIG. 5, in a subsequent step of the method;

FIG. 7 is a view of the spine similar to FIG. 6, in a subsequent step of the method;

FIG. 8 is a view of the spine similar to FIG. 7, in a subsequent step of the method;

FIG. 9 is a view of the spine similar to FIG. 8, in a subsequent step of the method;

FIG. 10 is a view of the spine similar to FIG. 9, in a subsequent step of the method;

FIG. 11 is a view of the spine similar to FIG. 10, in a subsequent step of the method; and

FIG. 12 is a view of the spine similar to FIG. 11, in a final step of the method, which corresponds to a sectional view taken along the line XII-XII of FIG. 4.

DESCRIPTION OF PREFERRED EMBODIMENTS

FIG. 4 shows a device usable in the method of the present invention to rotate a vertebra or vertebrae, the device including polyaxial screws 1, clamping parts 2, linking rods 3, tightening nuts 4, and set screws 5.

In some embodiments, the polyaxial screws 1, linking rods 3 and tightening nuts 4 may be as described in U.S. Pat. No. 6,267,765, the contents of which are incorporated herein by reference. As disclosed in this document and as shown on FIG. 5, each of the polyaxial screws 1 has an anchoring distal part intended to be anchored to a pedicle of a vertebrae 100 and a bearing portion 12 articulated with respect to the anchoring distal part. The anchoring distal part has a threaded portion 11 on a proximal part.

With reference now to FIGS. 1 and 2, each of the clamping parts 2 in a preferred embodiment includes a first part 20 delineating a first hole 21 for engagement on the threaded portion 11 of one of the polyaxial screws 1 and a second part 22 delineating a second hole 23 for receiving one of the linking rods 3. The second part 22 also delineates a third hole 24, which communicates with the second hole 23 and is tapped so as to receive one of the set screws 5. The second hole 23 includes a groove 25 opposite the third hole 24. In further embodiments, the clamping parts 2, tightening nuts 4, and set screws 5 may be as described in Published U.S. application 2006/167455, the contents of which also are incorporated herein by reference.

The method is now described with reference to the series of steps shown in FIGS. 5 to 12. Initially, two series of the polyaxial screws 1 are implanted in the respective left and right pedicules of the vertebrae 100, such as shown in FIG. 5 (the series of polyaxial screws 1 being visible in FIG. 4). As shown in FIG. 6, the clamping parts 2 are added to the polyaxial screws 1, one of the linking rods 3 is connected to one of the series, and another of the linking rods 3 is connected to a second of the series. The set screws 5 that engage the respective linking rods 3 are not tightened at this stage.

With reference to FIG. 7, tightening nuts 4 are engaged on respective threaded portions 11. The tightening nuts 4 for the series of polyaxial screws 1 on the convex side of the spine curvature (the convex side is the medial side on which the vertebral bodies are rotated, i.e. on the right in the figures) are tightened (FIG. 8) so as to tighten the clamping parts 2 of this series of polyaxial screws 1 against the bearing portions 12 of these screws 1 and to eliminate the polyaxiality of these screws 1.

With reference now to FIG. 9, the set screws 5 of the series of polyaxial screws 1 on the concave side of the spine curvature (opposite the convex side) are tightened, so as to immobilize the linking rod 3 of this series relative to the clamping parts 2 of this series.

As shown in FIGS. 10-11, the tightening nuts 4 of the series of polyaxial screws 1 on the concave side of the spine curvature are tightened, so as to move the clamping parts 2 of this series in the direction of the bearing portions 12 of the polyaxial screws 1 of this series until these clamping parts 2 reach these bearing portions 12, thus achieving a rotation of the vertebrae 100 about the axis of the linking rod 3 located on the convex side of the spine curvature. As seem in FIG. 11, a total reduction of the rotation of the vertebra 100 may be achieved.

The set screws 5 of the series of screws 1 on the former convex side of the spine curvature are tightened, so as to immobilize the linking rod 3 of this series with respect to the clamping parts 2 of this series (FIG. 12.)

As is apparent, this method does not include additional leverage instruments connected to the vertebrae. Further, one or more vertebra are rotated in a progressive and controlled way. Suitable torque instruments may be used to evaluate the stress applied.

While embodiments of the present invention have been described in the foregoing specification and drawings, it is to be understood that the present invention is defined by the following claims when read in light of the specification and drawings. 

1. A method for rotating a vertebra or vertebrae in a spine that is curved using a vertebral osteosynthesis device that includes polyaxial screws, linking rods, clamping parts, tightening nuts, and set screws, the method comprising the steps, in order, of: attaching two series of the polyaxial screws, clamping parts, and linking rods to the vertebrae; tightening the tightening nuts of a first series of the polyaxial screws on a convex side of the spine curvature so that the respective clamping parts engage the respective bearing parts; tightening the set screws of a second series of the polyaxial screws on a concave side of the spine curvature to immobilize the respective linking rod relative to the respective clamping parts; tightening the tightening nuts of the second series to rotate the vertebra; and tightening the set screws of the first series to immobilize the respective linking rod relative to the respective clamping parts.
 2. A method for rotating a vertebra or vertebrae in a spine that is curved using a vertebral osteosynthesis device that includes, polyaxial screws, each of which has an anchoring distal part for anchoring to a vertebra, a threaded portion, and a bearing portion articulated with respect to said anchoring distal part, linking rods, clamping parts, each of which comprises a first hole for engaging said threaded portion of one of said polyaxial screws and a second hole for receiving one of said linking rods, tightening nuts, each of which can be screwed on a respective said threaded portion of one of said polyaxial screws, and set screws, each of which engages a respective one of said linking rods in said second hole so as to immobilize the respective linking rod relative to the respective clamping part, the method comprising the steps of: implanting two series of said polyaxial screws in vertebrae of the spine; using said clamping parts, connecting one of said linking rods to a first said series of said polyaxial screws on a convex side of the spine curvature and another of said linking rods to a second said series on a concave side of the spine curvature (the convex side being the medial side on which the vertebra are rotated); completely tightening said tightening nuts on said first series of polyaxial screws, so as to tighten said clamping parts associated with said first series against said bearing portions thereof and to eliminate polyaxiality of said first series of polyaxial screws; completely tightening said set screws associated with said second series of said polyaxial screws, so as to immobilize said linking rod associated with said second series relative to said clamping parts thereof; tightening said tightening nuts on said second series of said polyaxial screws, so as to move said clamping parts of said second series in a direction of said bearing portions of said polyaxial screws of said second series until the respective said clamping parts reach the respective said bearing portions, thus achieving a rotation of the vertebrae about an axis of said linking rod associated with said first series; and completely tightening said set screws of said first series of polyaxial screws, so as to immobilize the linking rod of said first series with respect to said clamping parts associated with said second series.
 3. The method of claim 2, wherein each of said clamping parts further comprises a third hole that communicates with said second hole and receives one of said set screws, and wherein the steps of tightening said set screws includes tightening said set screw in said third hole into engagement with the respective said linking rod. 